Changes of Left Ventricular Diastolic Function in Normal Children

ABSTRACT

PURPOSE: Doppler echocardiography provides a noninvasive technique for the evaluation of left ventricular diastolic function. This study was performed to define the normal pattern of left ventricular diastolic filling by real-time Doppler flow mapping, and to determine how this pattern changes with aging in normal children. METHODS: The changes in diastolic function in 89 normal subjects less than 15 years old were assessed through the analysis of transmitral Doppler flow pattern. Diastolic time intervals, Doppler flow velocities and area fractions in early and late diastole were measured from mitral valve Doppler tracing. The changes in each variable with aging were determined. RESULTS: From the diastolic time intervals, acceleration and deceleration time increased significantly with aging. The percentage of isovolumic relaxation time to cycle length decreased with aging, but there were no significant differences in the percentage of acceleration and deceleration time to cycle length between each age group. The Doppler area of early diastolic flow, E and 0.33 area, significantly increased with aging than that of late diastolic flow, A area. The E and A area fractions to total area were significantly different in the age group of less than 2 months old compared with those of other age groups. The ratios of early to late diastolic flow velocities and early to late area fractions were increased with aging. CONCLUSION: Although many factors affect transmitral Doppler flow pattern, it is important to know the changes of left ventricular diastolic filling with aging to accurately evaluate diastolic dysfunction in children. Further investigation of work in large populations is needed to provide reference values of children with aging.